Xenleta vs. Zosyn

Xenleta (lefamulin) and Zosyn (piperacillin and tazobactam for injection) are used to treat pneumonia.

Zosyn is also used to treat many different infections caused by bacteria, such as urinary tract infections (UTIs), bone and joint infections, severe vaginal infections, stomach infections, and skin infections.

Xenleta and Zosyn are different types of antibiotics. Xenleta is a pleuromutilin and Zosyn is a combination of a penicillin antibiotic and a beta-lactamase inhibitor.

Side effects of Xenleta and Zosyn that are similar include injection site reactions, trouble sleeping (insomnia), headache, diarrhea, nausea, and vomiting.

Side effects of Xenleta that are different from Zosyn include elevated liver enzymes and low blood potassium.

Side effects of Zosyn that are different from Xenleta include dizziness, agitation, stomach pain or upset, constipation, runny nose, anxiety, skin rash or itching, and vaginal discharge or itching.

Xenleta may interact with strong CYP3A4 inducers or P-gp inducers, strong CYP3A inhibitors or P-gp inhibitors, alprazolam, diltiazem, verapamil, simvastatin, vardenafil, antiarrhythmics, antipsychotics, erythromycin, moxifloxacin, and tricyclic antidepressants.

Zosyn may interact with probenecid, antibiotics, blood thinners, or medications used to prevent blood clots.

Common side effects of Xenleta include:

• injection site reactions,
• elevated liver enzymes,
• nausea,
• low blood potassium,
• insomnia,
• headache,
• diarrhea,
• nausea, and
• vomiting

Common side effects of Zosyn include:

• swelling,
• redness,
• pain,
• soreness or
• irritation;
• dizziness,
• agitation,
• trouble sleeping (insomnia),
• nausea,
• vomiting,
• stomach pain or upset,
• diarrhea,
• constipation,
• headache,
• runny nose,
• anxiety,
• skin rash or
• itching, or
• vaginal discharge or itching.

Tell your doctor if you have serious side effects of Zosyn including muscle cramps or spasms, swelling of the arms/legs/hands/feet, easy bruising or bleeding, chest pain, confusion, new signs of infection (such as fever, persistent sore throat), severe abdominal or stomach pain, slow/fast/irregular heartbeat, persistent nausea or vomiting, seizures, extreme tiredness, dark or cloudy urine, change in the amount of urine, yellowing eyes or skin, or serious skin reactions (rash, peeling, sores, or blisters).

Xenleta (lefamulin) is a pleuromutilin antibacterial indicated for the treatment of adults with community-acquired bacterial pneumonia (CABP) caused by susceptible microorganisms.

Zosyn (piperacillin and tazobactam for injection) is a combination of two antibiotics used to treat many different infections caused by bacteria, such as urinary tract infections, bone and joint infections, severe vaginal infections, stomach infections, skin infections, and pneumonia. Zosyn is available in generic form.

Xenleta may interact with strong CYP3A4 inducers or P-gp inducers, strong CYP3A inhibitors or P-gp inhibitors, alprazolam, diltiazem, verapamil, simvastatin, vardenafil, antiarrhythmics, antipsychotics, erythromycin, moxifloxacin, and tricyclic antidepressants. Tell your doctor all medications and supplements you use. Xenleta is not recommended for use during pregnancy; it may harm a fetus. Females of reproductive potential are advised to use effective contraception during treatment with Xenleta and for 2 days after the final dose. It is unknown if Xenleta passes into breast milk. Because of the potential for adverse reactions in nursing infants, breastfeeding is not recommended while using Xenleta. Women should pump and discard breast milk for the duration of treatment with Xenleta and for 2 days after the final dose.

Zosyn may interact with probenecid, antibiotics, blood thinners, or any other medication used to prevent blood clots. Tell your doctor all medications you use.

The recommended dosage of Xenleta is 150 mg every 12 hours by intravenous infusion over 60 minutes for 5 to 7 days or 600 mg orally every 12 hours for 5 days.

The usual total daily dose of Zosyn for adults is 3.375 g every six hours totaling 13.5 g (12.0 g piperacillin/1.5 g tazobactam).